Achieving Diagnosis by Consensus

Abstract

This paper provides an analysis of the collaborative work conducted at a multidisciplinary medical team meeting, where a patient's definitive diagnosis is agreed, by consensus. The features that distinguish this process of diagnostic work by consensus are examined in depth. The current use of technology to support this collaborative activity is described, and experienced deficiencies are identified. Emphasis is placed on the visual and perceptual difficulty for individual specialities in making interpretations, and on how, through collaboration in discussion, definitive diagnosis is actually achieved. The challenge for providing adequate support for the multidisciplinary team at their meeting is outlined, given the multifaceted nature of the setting, i.e. patient management, educational, organizational and social functions, that need to be satisfied.

“Do no harm”: Fortifying MDT collaboration in changing technological times

“…MDTMs were introduced over 25 years ago as a mechanism of collaborative diagnosis and patient management. Intuitively they are good practice because all of the professional groups are involved in the clinical decisions affecting individual developments has led to this increase in the routine use of MDTMs: (i) clinical practice guidelines (CPGs) that specify that MDTMs should be used [4], (ii) increasingly specialised healthcare [5], (iii) recognition that diagnostic accuracy can be improved through clinical, radiological and pathology collaboration in the decision [6,2], and (iv) more complex treatment protocols that require high levels of coordination between specialist services [2]. Despite their popularity, it is acknowledged that there is little concrete evidence that patient outcomes benefit from MDT collaboration [7,8].…”

Design and Evaluation of Interaction Technology for Medical Team Meetings

“…Kane and Luz also discuss new technology's effect on group dynamics [8]. Often, participants already have a pre-defined role during the MDTMs, which would be affected by the introduction of tools that delegate control to other participants, an issue mentioned by several of our study participants.…”

“…[7,8]), show that surgeons often point to certain areas in medical images during MDTMs. The results from these earlier studies, and interview results from this study, suggest that using gestures far away from the projected images is neither sufficiently clear nor precise.…”

“…Several researchers report on detailed field studies of MDTMs [e.g., 5,6,7,8,9,11]. Time is an important aspect when judging the efficiency of the meeting [7,5] and supporting technology must take this into account, as well as specific participant roles [6].…”

“…Although some problems regarding efficiency and effects on the group work process were likely to arise, Kane and Luz [7] acknowledge the need for technology for collaborative decision-making. Unsupported needs include the ability to point to areas of interest and to make annotations on shared displays [8]. Laser pointers were shown to partially alleviate these deficiencies, although it was noted that the laser dot could not be seen at remote locations during teleconferencing meetings [7].…”